Adenoids surgery, or adenoidectomy as it is medically called, is surgery to remove adenoids in children. Practiced very commonly before, it is today much less but remains indicated in certain specific cases.

Invisible to the naked eye, adenoids, or adenoids, are small granulations located in the nasopharynx, at the upper limit of the throat, behind the nose and at the top of the palate. Formed of lymphoid tissue, they develop during the first year of life, reach their maximum volume between 1 and 3 years, then regress until they disappear around 10 years.

Like the tonsils, they play a role in immunity: strategically placed at the entrance to the respiratory system and containing immune cells, they help the body defend itself against bacteria and viruses. This role is important in the first years of a child’s life, much less after.

The operation of the adenoids, or adenoidectomy, will consist in removing this granular tissue which in some children leads to ENT complications. It is often combined with an operation of the tonsils (tonsillectomy) or the installation of a tympanic ventilator (“yoyo”) according to its indication.

The operation takes place under general anesthesia, by mask or injection.

The surgeon goes through the mouth in order to scrape the adenoids using a small curette. They are not removed completely in order to keep their base, where the tissue can regenerate. The gesture only takes a few minutes.

It is especially practiced in children between 4 and 7 years old.

In some children, the adenoids are constitutionally enlarged. They can then cause nasal obstruction, with snoring and sleep apnea which can have an impact on the good growth of the child. An adenoidectomy is then recommended in the event of persistent growth disorders and / or functional disorders. If an enlarged tonsils exists in parallel, adenoidectomy will be coupled with a tonsillectomy. 

Sometimes, the adenoids are too strained in their immune role, they grow, inflame or even become infected, obstruct the eustachian tubes and cause ear infections. After failure of medical treatment, adenoidectomy coupled with yoyo placement may be recommended in the presence of otitis media that is complicated or responsible for significant hearing loss. It can also be considered in cases of recurrent acute otitis media (AOM) (more than 3 episodes per year) after treatment failure and repercussions on the quality of life of the child. 

These are the two indications for the operation of the adenoids (1). An x-ray or a fibroscopy will objectively check the size of the adenoids.

Surgery on the adenoids for recurrent nasopharyngitis is, on the other hand, much less practiced today, because its effectiveness in this indication is questioned (2).

The operation is extremely rare in adults: and for good reason, in principle they no longer have any vegetation. If a lump exists at their location, it will need to be removed for a biopsy.

Operative suites

The operation usually takes place on an outpatient basis: the child can go home the same day.

The operative consequences are simple and not very painful. Paracetamol is enough to calm the child if he is in pain, especially when swallowing. A slight bloody blowing may persist for the first few hours after the operation. To facilitate eating, it is recommended to avoid foods that are too hot, too spicy, too hard.

The risks

They are few in number (3):

• bleeding that may require reoperation; very rarely, hemorrhage;
• the surgeon is of course careful, but it happens that the lip, the tongue or other part of the mouth is accidentally injured during the operation, or that a baby tooth suffers a small shock;
• a bronchopulmonary infection, following inhalation of blood during the procedure (rare);
• after healing, the voice may change, due to an air leak in the soft palate. speech therapy may be necessary
• a bronchopulmonary infection, following inhalation of blood during the procedure (rare);
• cervical infection (rare).